The URL can be used to link to this page

Home My WebLink About0025 JACQUELINE COURT - Health (2) Ira s- mac -T-j-�- , No.- ---•- Fins.... ................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. ApplirFaffou for Digpos al Works CTCnnitrnrtinn Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 0 Location-Address A or t o. ............ �✓�. .�'a......... '.................J. Ch......................... ....................�....J�� .....:.......--•-•------......-----...---.............--- Owner Ad ess a ......................• -------•._..._..•------••-•-........------....... ................. ------------------.........._............................................. Installer Address UType of Building <;` ��• � Size Lot----\s;_�.s�..�:....Sq. feet Dwelling L�No. of Bedrooms'....:.......................................Expansion Attic ( ) Garbage Grinder Vq Other—T e of Building No. of persons............................ Showers a Other—Type g -------------•-•--...------• P ( ) — Cafeteria ( ) Otherfixtures ......... --------------------------------------------------------------------------------------------•-----...-----------.................---- W Design Flow.............. .. .._ .._.._ 'gallons per pl;rson per day. Total daily flow.._.......330........_............gallons. t� Septic Tank I Liquid capacity... gallons Length................ Width................ Diameter................ Depth................ W Disposal Trench—No..................... Width_...___...._ Total Length....... Total leaching area....................sq. ft. x r Seepage Pit No._._f__________ Diameter.................... Depth below inlet...... Total leaching area.!; f.....sq. ft. Z Other Distribution box ( ) Dosin& tank ) `" Percolation Test Results Performed by... _U ....... _...�.' °"................. Date.........n............................ 1.4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fx, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---------•---------------------------------------------- ------ --------------------- O Description of Soil........0 Ci V LD - i - -- - - == -..._... - .....•---..!:�N G..q l-•t.----- ------------------------ ----------��z --------- U Nature of Repairs or Alterations—Answer when applicable.............................................. ..................... ................. ----•---......•---=-------------------------------------------------•-----------------...:-••••....----•--------------------------------------------------------------------------- ' -------........ Agreement: a The undersigned agrees to install the"aforedescribed Individual Sewage Disposal System in\accordance with the provisions of TITI.'. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until.a Certificate of Compliance has been issued by the board of health. AU GV Application Approved By..... w--- ..... Signe --•--------- ..------.//------ Date Application Disapproved for the following reasons--------------------------------------------------------•--------------------•-------------------------...----._ -•--------------------------------------------------------------------------------------••...-------•--•- ------------------------------------------------------- Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... O .........O F........'e C *t(l R ..................................... wrtif iratr of ToutoliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (W'�or Repaired ( ) ••... Insta has been installed in accordance witli tTze provisions of r r o The State Sanitary Code ads esc ib d in the �? f� application for Disposal Works Construction Permit No. .. .......LP d.............. da.ted_...�1"'_I THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION.SATISFACTORY. DATE.........�..�......-r't-.. .��1�..................................... Inspector........---- C .._. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /' ..........OF,...........± 'r .dP . ..�' �,/:� No........!v_ ........ FEE........................ Dispo.on1 Works C�nns r It panfit Permission is hereby granted . �. ...--'-------.............................. .................................................... to Construct e or Repair ( an Individual Sewage Disposal System t - -- Street as shown on the application for Disposal Works Construction PSzVt No _�._3._..__. :. Dated..... Y~... ........ _ Board of Health DATE--------------- --- ................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS No........... ._...f .............. THE COMMONWEALTH.OF MASSACHUSETTS �J BOAR® OF HEALTH �.................OF...... .04A.n..aN. \e.. Applirta#ion for Dispati al Works Tomitrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: 0 Location-Address . or Lot No. .... Gl!!n ..-- ..�<: S ?^_�__ ±........ ......: ..........•---�. !\_ _.4 .----------------------._......••--- \ ' y Owner Ad ess a •---•••••-• v l:............=�'..------....�'... 5....•.................... ............... :C �:.. ..5.C`` . -----................................ Installer Address Type of Build' Size Lot____h .,. ry� ...Sq. feet aDwelling 7No. of Bedrooms............3....._•.....__...•.........Expansion Attic ( ) Garbage Grinder ( ' p� Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Oa Other fixtures -•-••• •....•-•••••-••••-•••••••••...........•--- •- W Design Flow.............. . . ._..__,_gallons per person per day. Total daily flow.........33..........................gallons. W Septic Tank-L . capacity._gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width Total Length........__//. .__..._.Total leaching area....................sq. ft. 3 Seepage Pit No..../.............. Diameter......'..._. Depth below inlet.......(........ Total leaching area.-.g7®./....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by...--\3-( . ........�........_._:.7 n' �� 'Date Test Pit No. I................minutes per inch Depth of Test Pit........--.......... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----••----------------------•................................--......................................................................................... O Description of Soil......_b.---)-- ... .G�ry^� -k-- 5-"- �C-'- .................................................................. x -. ...............5 ja n_ --•&,- -z� ' '` --------------------------------------•-----------------........-------------- UNature of Repairs or Alterations—Answer when applicable............................................................................................... --------------••--•.••-•-----••-••••••---........•-••••-•------••-••---•----••-•-•----•-••--•........_.........-------------••-•-•---••-•---•---•••••--•---------•--•-••--••-•••••-•••-•....-•-•---•---. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITA LL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signe --....�� :--..... _r�. Application Approved By.....'_ J ` ! `� Y7...1� � Date Application Disapproved for the following reasons----------------------------------•- ............................................................ ..............................•--•----...•------•-••-•-------............••••--•--•--......•----•-------•._......_....-•••••-•••••••••--•-•-••••••••---•------------•-----....---•--- ......---------- Date PermitNo......................................................... Issued....................................................... Date �_ }' -�1�JG.t_L:...��Mll..�( -^3'�5t�t?1]UNl /9 °• �� 14 iaal L� F=Lc�w 110 �.. • 330 G.p.D. �, -�: �c_.P•t-Ic "rt�l< < 330,E trio % • d�•i5 6.Pc�.� � � �� i U SA- l OOb f A L-. q,lo O �,P� el PIT uSE on Ar (50 2.S • 3-75 G-P.V. y CID !6r$=. yt l .c t SO C�.R D. ►ot ��. i` :9 TOTAL 'p t=:SIGIJ T +�G.P.D. x oTAL T�QI l FL--( DN41 s J�6PU. Vb::42cDL&T%0Q O&TE : IU 2:�4t1N�OR LFfi�i. .a ISo U t .� OF IT A. luv• 9'1. co toyry ,1'P�e loco cuv '.� , 'L 4'PP� 1w. GAL- sde so�L -sox ; ,4G•6 5epnc Ic 4: t P G,eA ve t_ R r 9 wA4WF- C.SZTIFtElD PLb'T PL-..tip L b CA T'1 o t�1 C E NTERV 1 L l_ kie> Scta,Lt C1� -=I IN ��F7 �ATC >a(101 8a /V o Pt,A1�j jZi=rG-tom'sVlcS ;'-~ 1 CGIZTit✓�{ -ri4AT TPG— FOUND^T StiloWQ a: t-IF:1�t_L�IJ Gr�rV>,PL�IS W ITI-L TI-l�: �jIDE.t_t,-1� LO --r.- 1 (2 AL.1D �ET1 ,ACLC �C-4Utt:Editc�TS ot= TNC- 1 -To w Li ct-= $K z 9 o pG, S-7 ' C�A'fG .� •��-' B/s.ETC tit. �`;. 4-t�l1= �CGIs ttt;�u t A W0 SUZvaYoe Ti-Al-5 C�LAI-1 t 'r L:ASC� �1•.y A.�..t osTEev�t~! Uo A.NPt_tGA.1.JT- /yM�S K. SMtiT�-1� mot. r.. 1 _t•t-, !.. rjr;,-rr.rMt_bJl' 1 G G' (,,e h4i • ��I�.1�•LL' FAMILY( - 3 $1 72�OAA ,. T:=Low a t t o 3 • 33 d G.P.n. ��r k) c� I:K �r_-Pt't c 'rt ►c 4 33o,r ISo % • d s�5 6.P v.• (� ;3• .? USA 10OO 64L. O I o00 (g;aL. AV 0. :; I ISv `�F ' ,c 2.S • 3'7S G.P.D. � O 20 M `�'-� 8oT'rO�S/l LieEAs � ST=. /I�• TOTAL '•C)GG,1614 = •425 G•P n L �, TbTo L r->A.1 L:-( 1=LDW = 33D&P'D. r 9 3Z r t rzcoLaTtoU �ZOTE �..1w 2ml u•o¢ LT ,. ' .i`". OF AV A LA MCHARD k � A. 6 �p Sll%14 Aso �}�• ToP PUS, MA�11 s7n ... `�� II,Jd.• Q.7 00 La9M •Poe IOQo {its •.A Iw. 6,&L. 9G•s? j -Sox 9G•G� SEvnC Io � . Z 1mv. T"o�t►L l 000 BG.O ITV tW •t. !�s PcJ1L G,2.�►VCL PST si e / I sues SAND. ' :� saME .. . • tT=�TtFyCT� pl..b'T Pt_.!L1�1 sro NE Pczo�'t L� _�_ o>J — - -- -- ---- LoC.�.TI CEtyTF-R\I1 L_L� ELaper, IZ wo SG4.L� SCA C I {K.t QOF� >a(lo/ 8", NO GI.tzTtt=�{ TI--IAT TI-AC FovND^,rroN 5u�W PL-Ah1 Rr_r`�--�cE WE_I,t=LStJ CcAAPI-gG W!'rk TWi: LQT I rO 'TO w►� cr "HA R�1 S TA Z,L_51, pLA N 8K Z 4 U PG, S-1 07 ��x'%L� '!� �-�-� B,b��TC:Q- Gr UJ C .tQr-. ,IY t2CGtSt-r ,C:TJ LA.l•.l0 SUZVa—(O� ' o5'TEV-V%LU a Tt-t15 C7t_AaJ t LJOT P.ASC•D U1,4 AN L IlJ>C�:J•tnt:lJi <,Ut_�/l_`{ TNG UFc:�i_-T'�, �11Gti1LD APr-1LIGA I-JT �i�P��s h• MIT i . �..,r n r.. t t r h:r�► ' . t•ll r%'r r..l'AA I w{l- t_l Wa:i •* .�.� �`�•-�-�